Provider Demographics
NPI:1982014494
Name:BRINKER, CARLA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:
Last Name:BRINKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W WASHINGTON AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-1917
Mailing Address - Country:US
Mailing Address - Phone:484-602-4217
Mailing Address - Fax:
Practice Address - Street 1:2 W WASHINGTON AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-1917
Practice Address - Country:US
Practice Address - Phone:484-602-4217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00380700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health